The Fight for Black Men and Boys: What’s trauma got to do with it?

There is a growing movement to address the needs of black boys and young men, and with good reason. Irrespective of geography or social standing, American black boys and young men fare much worse than their white and Hispanic peers on all major indicators of well-being.

The barriers to opportunity for black youth are high and persistent, with achievement gaps, homicides, school expulsions, disproportionate contact with law enforcement, poverty, high unemployment and incarceration rates now the norm. Over the past few decades, these problems have gotten worse and more entrenched. A recent report by the Annie E. Casey Foundation, which examines a dozen milestones across five racial groups, highlights widening gaps between blacks and the other groups in education, health and overall well-being from birth to young adulthood. The study did not look at gender, but the authors said the index scores for African American children indicated a "national crisis."

While much of this work shines a spotlight on changing the social context, I would argue there is a more pressing question that isn't being considered. How can we address the cumulative psychological and even neurobiological effects of these problems on the most vulnerable black children -- both boys and girls?

There is a large body of research on the long-term impact of childhood trauma and its potential to create social, emotional and cognitive impairment. And it needs to be woven into this tapestry. In a previous blog, I mentioned the Adverse Childhood Experiences (ACE) study, which shows a strong relationship between exposure to trauma as a child and negative health outcomes as an adult, including chronic diseases. Exposure to violence, extreme poverty, maltreatment, indiscriminate suspensions and being funneled through a school to prison pipeline are not just unfortunate realities. They are traumatic experiences and can damage the brain and body in young children. Toxic stress (prolonged, frequent and strong adversity that overtaxes young systems without adequate protections to help kids recover) can alter brain architecture and feed cognitive impairment.

Take a moment -- think about this: trauma and toxic stress can cause developmental delays and behavioral difficulties, which can lead to preschool suspensions, which can lead to gaps in schooling, poor performance and more trouble at school, which can easily turn into dropping out altogether, a path that leads into the justice system.

Among those working with children, there is more talk about trauma and toxic stress -- and more talk than change in practice or wide scale adoption of proven interventions. As we look at the initiatives on behalf of black boys and men, trauma shouldn't be a footnote or even a "lens." We need bigger thinking on how to identify, prevent and heal serious child traumatic stress as a central component of our efforts to unlock the full potential of boys of color.

The Philadelphia Urban ACE Study released last year went beyond the original ACE questions to ask a sample of Philadelphians about other risk factors, including exposure to violence, racial/ethnic discrimination and overall safety. It found that males in Philadelphia witnessed violence and experienced discrimination at a higher rate than all racial groups, with black adults more likely to report adverse childhood experiences than white adults. Again, nothing terribly surprising here. The question is, how do we use this information to heal trauma in boys of color, particularly when we now know that early exposure to adversity breeds horrible outcomes?

Philadelphia is recognized nationally for its growing attention to ACEs and trauma. A task force comprised of leaders in public health, medicine, and other relevant systems has served as a platform for sharing information about what is working, such as hospital-based trauma interventions programs, and how to apply their collective knowledge to reach more kids. One idea that has emerged is extending trauma work beyond the medical field to engage youth and a wide variety of social service organizations in figuring out how to better identify and treat chronic exposure to trauma. Read about this here.

My future blogs will focus more on what seems to be working, and what initiatives are in need of scaling up to improve life outcomes for our kids. I want us to look more closely at our very young and most vulnerable black boys (and girls!) to ask them what makes them hurt. We must dig deeper to understand the behaviors and stressors and do more along the lifespan and within the family and community contexts to prevent and treat trauma where we find it. We must prioritize healing as we work to transform these lives.